Beck Depression Inventory - Depression Essay Example

Each year about 15 million adult Americans suffer from clinical depression - Beck Depression Inventory introduction. That is 8% of the American population age 18 and over (Depression Treatment, Signs, Medication, Causes, Test at Clinical Depression Center, 2010). Often people are depressed but unaware of the numerous treatments available to them. Seeking professional help from a physician or therapist is the first step to receive the proper treatment. There are various ways for a psychologist to determine if a person suffers from depression.

One way to aid in the diagnosis is to use the Beck Depression Inventory (BDI). The BDI is a self administered test that measures the patient’s experiences and symptoms that are associated with depression. This paper includes a summary of two articles, comparing and contrasting these articles, and determining who is qualified to administer the BDI. Differentiating between the populations for which the BDI measures and whether the test is valid or invalid are also discussed.

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Summary of 1st BDI Article. The article summarized is a review of the Beck Depression Inventory (BDI) by Janet F. Carlson, Associate Professor, Counseling and Psychological Services Department, State University of New York at Oswego, Oswego, NY. The BDI is a well-known and widely used self report inventory that was implemented for the purpose of finding the severity of depression in adults and adolescents. In 1961 Beck and his associates developed the BDI and later revised the report in 1971, at which time it was introduced to the Center or Cognitive Therapy (CCT) at the University of Pennsylvania Medical School (Beck & Steer, 1993). Carlson (2010) discusses in this article the Applications, Administering, Scoring, and Interpretation, Technical Aspects, and Critiques of the BDI. According to Carlson (2010), the application of the BDI has expanded well beyond its original intent, but indicates that it is a good form of screening depression for clinicians. She goes on to explain how practitioners have found the BDI useful in other contexts such as research, screening, and the assessment of therapeutic outcomes.

The administering, scoring, and interpretation of the BDI may be administered individually or in a group setting, in written or oral form. Carlson (2010) goes on to explain that the 1993 version of the BDI taps into more trait aspects of depression instead of the earlier versions that measured state aspects of depression. The test takes about 15 minutes, and is based on a total score from zero to 63. Among depressed patients zero to nine denotes minimal depression and 30 to 63 is severe depression. Within the normal population, total scores of 15 may indicate possible depression.

The technical aspects of the BDI focus on the reliability and validity of the test manual. Carlson (2010), states that the test manual takes into account gender and race distribution of normative samples and normative-outpatient samples. The failure she notes is that the test manual is not as good as the BDI literature therefore those giving the test should read and research the literature before administering the test. Carlson’s critique is favorable and supportive of the BDI when used in the intended population.

She also recognizes that the BDI has been around 35 years, and is a solid contributor in measuring depression. Although she states that the BDI is best used as a screening instrument for depression, and should not serve as the sole means by which depression is assessed. Summary of 2nd BDI Article Luty and O’Gara (2006) stated the original self-administered BDI test containing 21 items, has been used in a variety of settings however, the test has not been validated against another instrument in depressed alcohol-dependent people.

The abbreviated 13-item BDI was given to 108 alcohol-dependent people seeking treatment to validate the BDI, and to observe the treatment outcomes of these patients. According to Luty and O’Gara (2006), the BDI is particularly important to validate instruments in the population to which they are applied as the symptoms of the primary condition (in this case alcohol dependence). In this study the MADRS and Ham-D were also used. In general, these two tests are found to be more time-consuming as a health professional is required to administer the test, which takes approximately 15-20 minutes each.

Although the MADRS and Ham-D are widely used and validated with time restraints, and minimal staffing these tests are often thought of as inconvenient, and the staff is unlikely to have received the proper training to administer the test. The primary reason for the study was to validate the BDI in alcohol dependent patients as a measure that was sensitive to treatment with antidepressants (Luty & O’Gara, 2006). The outcome of the study proved the 13 item BDI was just as feasible, reliable, and a valid option for monitoring depressive symptoms in alcohol dependent people seeking treatment, especially in a short staffed facility.

The BDI was found to have high consistency and high correlation compared to the MDRS and Ham-D. Comparing and Contrasting the Articles The first article discusses the history and established effectiveness of the Beck Depression Inventory. The second mentions the well established effectiveness of the BDI, but seeks primarily to validate the use of the test in revealing levels of depression of alcohol-dependent individuals. The first article gives statistics to validate the success of the BDI, whereas the second gives statistics contrasting and comparing the BDI with the MADRS and the Ham-D.

The first article gives the strengths and weaknesses of the BDI and a positive review. The second article explains that after studies and comparisons were made the conclusion was that the BDI is a valid test that can be effectively used with alcohol-dependent people. Both articles praise the BDI, and indicate that the BDI has been used for much broader applications than originally intended. The first article validates the use of the BDI for the average individual who may be depressed.

The second article specifically identifies the BDI as useful in identifying depression in individuals abusing alcohol. This is extremely valuable as this group tends to be particularly susceptible to suicide. The individual(s) Administering the BDI The Beck Depression Inventory is a useful tool in the mental health community, yet is not designed to be used for the diagnosis of depression. The Beck Depression Inventory (BDI) is a self-completed scale that comes in short and long versions.

The BDI is the most widely used self-rating instrument for depressive symptoms (Carlson, 2010). Each question is designed to measure emotions and thoughts related to depression such as hopelessness, irritability, and guilt. It also measures physical symptoms of depression such as fatigue, decreased libido, and weight loss. The questions on the BDI were written directly from patient statements, creating a test patients could directly identify with. This was the first test of its kind (Beck, et. al. , 1961).

The issue is not who can administer the test because it is self-completed. The issue is who should interpret the BDI. Although the Beck Depression Scale may appear simple to understand and interpret, it has been developed specifically for health care professionals who have undergone training in administering, analyzing, evaluating, and interpreting the results. Each of the inventory items correspond to a specific category of depressive symptom and attitudes according to DSM-IV. The statements are rank ordered and weighted.

Beck admits that there is no arbitrary cutoff score and the specific cutoff depends on the characteristics of the patients used and the purpose for which the inventory is given (1961). As evidenced in the aforementioned articles, the BDI serves as a good assessment tool in measuring depression in different settings. It is useful in both in and outpatient settings, as the BDI measures symptoms at the time of testing, and is quick, and easy to understand. The Beck Depression Inventory should always be administered and interpreted only by a trained clinical professional.

Population(s) the BDI Measures and the Validity The BDI suffers from the same problems as other self-report inventories because scores can be exaggerated or minimized by the individual (age 13 and over) completing them. Like all questionnaires, the way the test is administered can affect the final score. If a patient is asked to fill out the form in a clinical environment, social expectations may elicit a different response compared to administration in a private setting.

In participants with an array of physical illness or physical symptoms such as fatigue may artificially inflate scores because of the symptoms rather than the actual depression. Beck and his colleagues developed the BDI-II and the Beck Depression Inventory for Primary Care (BDI-PC), which is a short screening scale consisting of seven items from the BDI-II considered to be independent of physical function. The BDI-PC produces a binary outcome of “not depressed” or “depressed” for patients above a cutoff score of four.

Although designed as a screening device rather than a diagnostic tool, the BDI is sometimes used by health care providers to reach a quick diagnosis (The Psychological Corporation, n. d. ). The BDI-II is used to measure the severity of depression in adults and adolescents age 13 and over, who have had psychiatric treatment. It is not meant to be used for diagnosing depression, but to identify the severity of symptoms that fit with the criteria of the DSM-IV. The creators of the test warn against the BDI as a sole diagnostic measure of depression (The Psychological Corporation, n. d. ).

The BDI-II “is a 21-item self-report used to examine the severity and existence of depression as listed in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders 4th edition” (DSM-IV, p. 349, 2000). This revised edition replaces the BDI and the BDI-1A, and includes items used to index symptoms of severe depression that would require hospitalization. Items have been changed to show increases or decreases in appetite, sleep, work problems, body image, and weight loss. Many statements have been reworded resulting in a better report of the original BDI.

When patients are presented with the BDI-II, they are to consider each statement as it relates to the way they have been feeling for the past two weeks, which corresponds more accurately to the DSM-IV criteria (The Psychological Corporation, n. d. ). One of the reasons for the new version of the BDI is to conform more closely to the diagnostic criteria for depression. The BDI-II eliminated and reworded items to assess accurately the symptoms of depression in the DSM-IV, which increased the content validity of the measure. The BDI-II scores on average, are three points igher in accuracy than the other two BDI tests, thus factorial validity has been established (The Psychological Corporation, n. d. ). Conclusion The BDI has proven to be a valuable instrument in determining whether a person is depressed and the severity of the depression. Beck and his co-authors have made important strides in forming various inventories such as the BDI-II and the BDI-PC to further measure and validate depression in adolescents and adults. Whether the test is administered to alcohol dependent people or the general population, the BDI has shown to be an effective starting point in determining depression.